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The authors respond.

We thank Drs. Baumbacher, Mulder, Bermudes, and Beck for their insightful comments. TMS is an interesting neuromodulation technique that needs to be considered when assessing treatment resistance. In the same vein, vagus nerve stimulation' and deep brain stimulation2 also could be added to a thorough evaluation of treatment resistance, because these techniques may be used increasingly in the future. We have added these techniques to a revision of the ATRQ specifically designed to assess augmentation trials.

Martin Desseilles, MD, PhD Lecturer, Department of Psychiatry University of Liege, Belgium Researcher, Department of Psychiatry

Maurizio Fava, MD Slater Family Professors of Psychiatry Department of Psychiatry

David Mischoulon, MD, PhD Associate Professor Department of Psychiatry

Marlene P. Freeman, MD Associate Professor Department of Psychiatry Clinical Trials Network and Institute Massachusetts General Hospital Harvard Medical School Boston, MA


(1.) U.S. Department of Health and Human Services. Agency for Healthcare Research and Quality. Nonpharmacologic interventions for treatment-resistant depression in adults. pageaction=displayproduct. Published September 23, 2011. Accessed Apri119, 2012.


(1.) Corcoran CD, Thomas P. Phillips J, et al. Vagus nerve stimulation in chronic treatment-resistant depression: preliminary findings of an open-label study. Br J Psychiatry. 2006;189:282-283.

(2.) Bewernick RH, Kayser S, Sturm V, et al. Long-term effects of nucleus accumbens deep brain stimulation in treatment-resistant depression: evidence for sustained efficacy [published online aheadof print April 4, 2012]. Neuropsychopharmacology. doi: 10.1038/npp.2012.44.

Gordon Baumbacher, MD Caroline Mulder, MD Private Practice Corte Madera, CA Richard Bermudes, MD Private Practice Sacramento, CA Jennifer Beck, MD Private Practice Santa Rosa, CA

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Title Annotation:Comments&Controversies
Author:Desseilles, Martin; Fava, Maurizio; Mischoulon, David; Freeman, Marlene P.
Publication:Current Psychiatry
Article Type:Editorial
Date:Jun 1, 2012
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